| 1. |
- Bongiorni, Maria Grazia, et al.
(författare)
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Current practice in transvenous lead extraction : a European Heart Rhythm Association EP Network Survey
- 2012
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:6, s. 783-786
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Current practice with regard to transvenous lead extraction among European implanting centres was analysed by this survey. METHODS AND RESULTS: Among all contacted centres, 164, from 30 countries, declared that they perform transvenous lead extraction and answered 58 questions with a compliance rate of 99.9%. Data from the survey show that there seems to be an overall increasing experience of managing various techniques of lead extraction and a widespread involvement of cardiac centres in this treatment. Results and complication rates seem comparable with those of main international registries. CONCLUSION: This survey gives an interesting snapshot of lead extraction in Europe today and gives some clues for future research and prospective European registries.
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| 2. |
- Bongiorni, Maria Grazia, et al.
(författare)
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EHRA research network surveys : 6 years of EP wires activity
- 2015
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 17:11
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Tidskriftsartikel (refereegranskat)abstract
- Clinical practice should follow guidelines and recommendations mainly based on the results of controlled trials, which are often conducted in selected populations and special conditions, whereas clinical practice may be influenced by factors different from controlled scientific studies. Hence, the real-world setting is better assessed by the observational registries enrolling patients for longer periods of time. However, this may be difficult, expensive, and time-consuming. In 2009, the Scientific Initiatives Committee of the European Heart Rhythm Association (EHRA) has instigated a series of surveys covering the controversial issues in clinical electrophysiology (EP). With this in mind, an EHRA EP research network has been created, which included EP centres in Europe among which the surveys on 'hot topic' were circulated. This review summarizes the overall experience conducting EP wires over the past 6 years, categorizing and assessing the topics regarding clinical EP, and evaluating the acceptance and feedback from the responding centres, in order to improve participation in the surveys and better address the research needs and aspirations of the European EP community.
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| 3. |
- Bongiorni, Maria Grazia, et al.
(författare)
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Preferred tools and techniques for implantation of cardiac electronic devices in Europe : results of the European Heart Rhythm Association survey
- 2013
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 15:11, s. 1664-1668
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to the tools and techniques used for cardiac implantable electronic devices procedures in the European countries. Responses to the questionnaire were received from 62 members of the EHRA research network. The survey involved high-, medium-, and low-volume implanting centres, performing, respectively, more than 200, 100199 and under 100 implants per year. The following topics were explored: the side approach for implantation, surgical techniques for pocket incision, first venous access for lead implantation, preference of lead fixation, preferred coil number for implantable cardioverter-defibrillator (ICD) leads, right ventricular pacing site, generator placement site, subcutaneous ICD implantation, specific tools and techniques for cardiac resynchronization therapy (CRT), lead implantation sequence in CRT, coronary sinus cannulation technique, target site for left ventricular lead placement, strategy in left ventricular lead implant failure, mean CRT implantation time, optimization of the atrioventricular (AV) and ventriculo-ventricular intervals, CRT implants in patients with permanent atrial fibrillation, AV node ablation in patients with permanent AF. This panoramic view allows us to find out the operator preferences regarding the techniques and tools for device implantation in Europe. The results showed different practices in all the fields we investigated, nevertheless the survey also outlines a good adherence to the common standards and recommendations.
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| 4. |
- Dagres, Nikolaos, et al.
(författare)
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Current ablation techniques for persistent atrial fibrillation : results of the European Heart Rhythm Association Survey
- 2015
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 17:10
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this survey was to provide insight into current practice regarding ablation of persistent atrial fibrillation (AF) among members of the European Heart Rhythm Association electrophysiology research network. Thirty centres responded to the survey. The main ablation technique for first-time ablation was stand-alone pulmonary vein isolation (PVI): in 67% of the centres for persistent but not long-standing AF and in 37% of the centres for long-standing persistent AF as well. Other applied techniques were ablation of fractionated electrograms, placement of linear lesions, stepwise approach until AF termination, and substrate mapping and isolation of low-voltage areas. However, the percentage of centres applying these techniques during first ablation did not exceed 25% for any technique. When stand-alone PVI was performed in patients with persistent but not long-standing AF, the majority (80%) of the centres used an irrigated radiofrequency ablation catheter whereas 20% of the respondents used the cryoballoon. Similar results were reported for ablation of long-standing persistent AF (radiofrequency 90%, cryoballoon 10%). Neither rotor mapping nor one-shot ablation tools were used as the main first-time ablation methods. Systematic search for non-pulmonary vein triggers was performed only in 10% of the centres. Most common 1-year success rate off antiarrhythmic drugs was 50-60%. Only 27% of the centres knew their 5-year results. In conclusion, patients with persistent AF represent a significant proportion of AF patients undergoing ablation. There is a shift towards stand-alone PVI being the primary choice in many centres for first-time ablation in these patients. The wide variation in the use of additional techniques and in the choice of endpoints reflects the uncertainties and lack of guidance regarding the most optimal approach. Procedural success rates are modest and long-term outcomes are unknown in most centres.
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| 5. |
- Dagres, Nikolaos, et al.
(författare)
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Current practice of antiarrhythmic drug therapy for prevention of atrial fibrillation in Europe : The European Heart Rhythm Association survey
- 2013
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 15:4, s. 478-481
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this survey was to provide insight into current practice regarding the use of antiarrhythmic drugs for atrial fibrillation (AF) among members of the European Heart Rhythm Association research network. Thirty-seven centres responded. Rhythm control was preferred in patients with significant AF-related symptoms by 73 of centres, in all patients after a first detected episode by 59, and in young patients even if AF was well tolerated by 49 of centres. The most common strategy after successful conversion of the first AF episode was a wait-and-see approach without initiation of antiarrhythmic drugs (49). Conventional -blockers were always or sometimes used as first-choice drugs for AF prevention by 76 of centres. Only 11 used dronedarone regularly as a first-choice drug. The diagnostic work-up for exclusion of heart disease prior to initiation of class IC antiarrhythmic drugs was limited. Markers monitored for proarrhythmia risk were QRS duration for class IC drugs (68) and the QT interval for sotalol and amiodarone (65). In conclusion, rhythm control is more widely employed than expected. Beta-blockers are widely used for AF prevention in contrast to the limited use of the new drug dronedarone.
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| 6. |
- Deharo, Jean-Claude, et al.
(författare)
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Perioperative management of antithrombotic treatment during implantation or revision of cardiac implantable electronic devices : the European Snapshot Survey on Procedural Routines for Electronic Device Implantation (ESS-PREDI)
- 2016
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 18:5, s. 778-784
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Tidskriftsartikel (refereegranskat)abstract
- The European Snapshot Survey on Procedural Routines for Electronic Device Implantation (ESS-PREDI) was a prospective European survey of consecutive adults who had undergone implantation/surgical revision of a cardiac implantable electronic device (CIED) on chronic antithrombotic therapy (enrolment March-June 2015). The aim of the survey was to investigate perioperative treatment with oral anticoagulants and antiplatelets in CIED implantation or surgical revision and to determine the incidence of complications, including clinically significant pocket haematomas. Information on antithrombotic therapy before and after surgery and bleeding and thromboembolic complications occurring after the intervention was collected at first follow-up. The study population comprised 723 patients (66.7% men, 76.9% aged a parts per thousand yen66 years). Antithrombotic treatment was continued during surgery in 489 (67.6%) patients; 6 (0.8%) had their treatment definitively stopped; 46 (6.4%) were switched to another antithrombotic therapy. Heparin bridging was used in 55 out of 154 (35.8%) patients when interrupting vitamin K antagonist (VKA) treatment. Non-vitamin K oral anticoagulant (NOAC) treatment was interrupted in 88.7% of patients, with heparin bridging in 25.6%, but accounted for only 25.3% of the oral anticoagulants used. A total of 108 complications were observed in 98 patients. No intracranial haemorrhage or embolic events were observed. Chronic NOAC treatment before surgery was associated with lower rates of minor pocket haematoma (1.4%; P= 0.042) vs. dual antiplatelet therapy (13.0%), VKA (11.4%), VKA + antiplatelet (9.2%), or NOAC + antiplatelet (7.7%). Similar results were observed for bleeding complications (P= 0.028). Perioperative management of patients undergoing CIED implantation/surgical revision while on chronic antithrombotic therapy varies, with evidence of a disparity between guideline recommendations and practice patterns in Europe. Haemorrhagic complications were significantly less frequent in patients treated with NOACs. Despite this, the incidence of severe pocket haematomas was low.
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| 7. |
- Grazia Bongiorni, Maria, et al.
(författare)
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Management of malfunctioning and recalled pacemaker and defibrillator leads : results of the European Heart Rhythm Association survey
- 2014
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 16:11, s. 1674-1678
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this survey was to describe the different strategies regarding the management of malfunctioning and recalled pacemaker and defibrillator leads across Europe. A questionnaire has been designed to assess the current practice and physician's approach to the management of leads which are faulty, unnecessary, and/or recalled. Responses to the questionnaire were received from 34 hospitals-members of the European Heart Rhythm Association (EHRA) electrophysiology (EP) research network. The survey involved both very high and low volume implanting centres, with 85% of the responding centres performing lead extraction. The survey provides a panoramic view of operator's decision making in the field of malfunctioning, recalled, and redundant leads and outlines a common point of view on lead abandonment and factors influencing the decision about lead extraction. The main factors strongly influencing the decision making were patient's age (59%), the presence of the damaged leads (44%), and the lead dwelling time (44%). Regarding the lead abandonment, the main concern (61%) was the potential greater difficulty associated with lead extraction in the future. High volume extracting centres showed a greater propensity to removing the malfunctioning or recalled leads compared with low volume or non-extracting centres. This EP Wire survey gives a snapshot of the operators' approaches and options regarding redundant, malfunctioning, and recalled lead management and may form the basis for future prospective research on this topic.
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| 8. |
- Hernandez-Madrid, Antonio, et al.
(författare)
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How are arrhythmias managed in the paediatric population in Europe? : Results of the European Heart Rhythm survey
- 2014
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 16:12, s. 1852-1856
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this survey was to provide insight into current practice regarding the management of paediatric arrhythmias in Europe. The survey was based on a questionnaire sent via the Internet to the European Heart Rhythm Association (EHRA) electrophysiology research network centres. The following topics were explored: patient and treatment selection, techniques and equipment, treatment outcomes and complications. The vast majority of paediatric arrhythmias concerns children older than 1 year and patients with grown-up congenital heart disease. In 65% of the hospitals there is a specialized paediatric centre, and the most commonly observed arrhythmias include Wolff-Parkinson-White syndrome and atrioventricular nodal re-entry tachycardias (90.24%). The medical staff performing paediatric catheter ablations in Europe are mainly adult electrophysiology teams (82.05% of the centres). Radiofrequency is the preferred energy source used for paediatric arrhythmia ablation. Catheter ablation is only chosen if two or more antiarrhythmic drugs have failed (94.59% of the centres). The majority of the centres use flecainide (37.8%) or atenolol (32.4%) as their first choice drug for prevention of recurrent supraventricular arrhythmias. While none of the centres performed catheter ablation in asymptomatic infants with pre-excitation, 29.7% recommend ablation in asymptomatic children and adolescents. The preferred choice for pacemaker leads in infants less than 1 year old is implantation of epicardial leads in 97.3% of the centres, which continues to be the routine even in patients between 1 and 5 years of age as reported by 75.68% of the hospitals. Almost all centres (94.59%) report equally small number of complications of catheter ablation in children (aged 1-14 years) as observed in adults.
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| 9. |
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| 10. |
- Hocini, Meleze, et al.
(författare)
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Diagnosis and management of patients with inherited arrhythmia syndromes in Europe : results of the European Heart Rhythm Association Survey
- 2014
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 16:4, s. 600-603
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Tidskriftsartikel (refereegranskat)abstract
- Inherited arrhythmia disorders associated with structurally normal heart (i.e. long and short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, early repolarization syndrome, idiopathic ventricular fibrillation) cause 10 of 1.1 million sudden deaths in Europe and the USA. The purpose of this European Heart Rhythm Association (EHRA) electrophysiology wire survey was to assess the European clinical practice adopted for the diagnosis and management of these disorders. The survey was based on an electronic questionnaire sent out to the EHRA Research Network centres. Responses were received from 50 centres in 23 countries. The results of the survey show that inherited arrhythmia syndromes have a relatively low burden and are diagnosed and managed in accordance with the current guidelines. However, more than 50 of centres do not participate in any existing registry underlining the need for establishing a pan-European registry of these disorders.
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